  <table width="676" border="0" cellpadding="2" cellspacing="0">
  <tr>
	  <td colspan="2"><img src="/images/print/globelogo.png" alt="" width="120" height="50" border="0" /></td>
    <td align="right" colspan="2">Reference no.: <?php echo $application['ref_number'] ?></td>
	  </tr>
	<tr>
	  <td colspan="4" style="background-color:#2e62ad;"><h1>CORPORATE MANAGED</h1></td>
	  </tr>
	<tr>
	  <td colspan="4" style="background-color:#2e62ad;">
      <h2>COMPANY INFORMATION</h2>
      <div class="pls">
        Please fill-out completely. The shaded portion is for GLOBE TELECOM use only
        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
        <span style="color:red">* required fields</span>
      </div>
    </td>
	  </tr>
	<tr>
	  <td valign="top">1.</td>
	  <td colspan="3" valign="top">COMPANY NAME</td>
	  </tr>
	<tr>
	  <td width="20" valign="top">&nbsp;</td>
	  <td colspan="3" valign="top"><div class="longertxt"><?php echo (isset($application['company_name'])) ? $application['company_name'] : '' ?></div></td>
	  </tr>
	<tr>
	  <td valign="top">2.</td>
	  <td colspan="3" align="left" valign="top"><label>BUSINESS ADDRESS <span>Unit No./Floor/BUilding Name/Streeet No./Street name*</span></label>
	    <div class="longertxt"><?php echo (isset($application['business_address'])) ? $application['business_address'] : '' ?></div>
    </td>
	  </tr>
	<tr>
	  <td valign="top">&nbsp;</td>
	  <td colspan="3" valign="top"><label>BARANGAY/MUNICIPALITY/TOWN</label>
      <div class="longtxt"><?php echo (isset($application['business_brgy_municipality_town'])) ? $application['business_brgy_municipality_town'] : '' ?></div>
    </td>
	  </tr>
	<tr>
	  <td valign="top">&nbsp;</td>
	  <td width="261" valign="top"><label>CITY/PROVINCE</label>
      <div class="shortxt"><?php echo (isset($application['business_city_province'])) ? $application['business_city_province'] : '' ?></div>
    </td>
	  <td width="365" valign="top"><label>POSTAL CODE</label>
      <div class="shortxt"><?php echo (isset($application['business_postal_code_zip_code'])) ? $application['business_postal_code_zip_code'] : '' ?></div>
    </td>
	  </tr>
	<tr>
	  <td valign="top">3.</td>
	  <td colspan="3" valign="top">
      <input type="checkbox" name="" value="" <?php echo (strtoupper($application['number_of_employees']) == '1-50') ? 'checked="checked"' : '' ?>  />1-50&nbsp;&nbsp;&nbsp;
      <input type="checkbox" name="" value="" <?php echo (strtoupper($application['number_of_employees']) == '51-100') ? 'checked="checked"' : '' ?>  />51-100&nbsp;&nbsp;&nbsp;
      <input type="checkbox" name="" value="" <?php echo (strtoupper($application['number_of_employees']) == '101-200') ? 'checked="checked"' : '' ?>  /> 101-200&nbsp;&nbsp;&nbsp;
      <input type="checkbox" name="" value="" <?php echo (strtoupper($application['number_of_employees']) == '201-500') ? 'checked="checked"' : '' ?>  />201-500&nbsp;&nbsp;&nbsp;
      <input type="checkbox" name="" value="" <?php echo (strtoupper($application['number_of_employees']) == '501-1,000') ? 'checked="checked"' : '' ?>  />501-1,000&nbsp;&nbsp;&nbsp;
      <input type="checkbox" name="" value="" <?php echo (strtoupper($application['number_of_employees']) == '1,001 &AMP UP') ? 'checked="checked"' : '' ?>  />1,001 &amp; UP</td>
	  </tr>
	<tr>
	  <td valign="top">4. </td>
	  <td colspan="3" valign="top">NATURE OF BUSINESS</td>
	  </tr>
	<tr>
	  <td valign="top">&nbsp;</td>
	  <td colspan="3" valign="top">


      <table width="640" border="0">
	    <tr>
	      <td width="209"><input type="checkbox" name="" value="" <?php echo (strtoupper($application['nature_of_business']) == 'GOVERNMENT') ? 'checked="checked"' : '' ?>  />
	        GOVERNMENT</td>
	      <td width="182"><input type="checkbox" name="" value="" <?php echo (strtoupper($application['nature_of_business']) == 'BANKING') ? 'checked="checked"' : '' ?>  />
	        BANKING</td>
	      <td width="236"><input type="checkbox" name="" value="" <?php echo (strtoupper($application['nature_of_business']) == 'SEMICON &AMP; ELECTRONICS') ? 'checked="checked"' : '' ?>  />SEMICON &amp; ELECTRONICS</td>
	      </tr>
	    <tr>
	      <td><input type="checkbox" name="input" value="" <?php echo (strtoupper($application['nature_of_business']) == 'BPO/CALL CENTER') ? 'checked="checked"' : '' ?>  />
	        BPO/CALL CENTER</td>
	      <td><input type="checkbox" name="input" value="" <?php echo (strtoupper($application['nature_of_business']) == 'LOGISTICS') ? 'checked="checked"' : '' ?>  />
	        LOGISTICS</td>
	      <td><input type="checkbox" name="input" value="" <?php echo (strtoupper($application['nature_of_business']) == 'PHARMACEUTICALS') ? 'checked="checked"' : '' ?>  />PHARMACEUTICALS</td>
	      </tr>
	    <tr>
	      <td><input type="checkbox" name="input" value="" <?php echo (strtoupper($application['nature_of_business']) == 'HOLDINGS COMPANY') ? 'checked="checked"' : '' ?>  />
	        HOLDINGS COMPANY</td>
	      <td><input type="checkbox" name="input" value="" <?php echo (strtoupper($application['nature_of_business']) == 'TRANSPORT &AMP; FREIGHT') ? 'checked="checked"' : '' ?>  />TRANSPORT &amp; FREIGHT</td>
	      <td><input type="checkbox" name="input" value="" <?php echo (strtoupper($application['nature_of_business']) == 'GLOBAL SERVICE PROVIDER') ? 'checked="checked"' : '' ?>  />GLOBAL SERVICE PROVIDER</td>
	      </tr>
	    <tr>
	      <td><input type="checkbox" name="input" value="" <?php echo (strtoupper($application['nature_of_business']) == 'POWER &AMP; UTILITIES') ? 'checked="checked"' : '' ?>  />
	        POWER &amp; UTILITIES</td>
	      <td><input type="checkbox" name="input" value="" <?php echo (strtoupper($application['nature_of_business']) == 'RETAIL') ? 'checked="checked"' : '' ?>  />RETAIL</td>
	      <td><input type="checkbox" name="input" value="" <?php echo (strtoupper($application['nature_of_business']) == 'LOCAL TELCO/ISP') ? 'checked="checked"' : '' ?>  />LOCAL TELCOM/ISP</td>
	      </tr>
	    <tr>
	      <td><input type="checkbox" name="input" value="" <?php echo (strtoupper($application['nature_of_business']) == 'PETROLEUM') ? 'checked="checked"' : '' ?>  />
	        PETROLEUM</td>
	      <td><input type="checkbox" name="input" value="" <?php echo (strtoupper($application['nature_of_business']) == 'HOTELS &AMP; RESORTS') ? 'checked="checked"' : '' ?>  />HOTELS &amp; RESORTS</td>
	      <td><input type="checkbox" name="input" value="" <?php echo (strtoupper($application['nature_of_business']) == 'MEDIA') ? 'checked="checked"' : '' ?>  />MEDIA</td>
	      </tr>
	    <tr>
	      <td><input type="checkbox" name="input" value="" <?php echo (strtoupper($application['nature_of_business']) == 'INSURANCE') ? 'checked="checked"' : '' ?>  />
	        INSURANCE</td>
	      <td><input type="checkbox" name="input" value="" <?php echo (strtoupper($application['nature_of_business']) == 'MANUFACTURING') ? 'checked="checked"' : '' ?>  />MANUFACTURING</td>
	      <td>&nbsp;</td>
	      </tr>
	    </table>


        </td>
	  </tr>
	<tr>
	  <td valign="top">5.</td>
	  <td colspan="3" valign="top"><input type="checkbox" name="" value="" <?php echo (strtoupper($application['latest_ranking_of_company']) == 'TOP 50') ? 'checked="checked"' : '' ?>  />
	    TOP 50&nbsp;&nbsp;&nbsp;
      <input type="checkbox" name="" value="" <?php echo (strtoupper($application['latest_ranking_of_company']) == 'TOP 100') ? 'checked="checked"' : '' ?>  />
	    TOP 100&nbsp;&nbsp;&nbsp;
	    <input type="checkbox" name="" value="" <?php echo (strtoupper($application['latest_ranking_of_company']) == 'TOP 250') ? 'checked="checked"' : '' ?>  />
	    TOP 250&nbsp;&nbsp;&nbsp;
      <input type="checkbox" name="" value="" <?php echo (strtoupper($application['latest_ranking_of_company']) == 'TOP 500') ? 'checked="checked"' : '' ?>  />
	    TOP 500&nbsp;&nbsp;&nbsp;
	    <input type="checkbox" name="" value="" <?php echo (strtoupper($application['latest_ranking_of_company']) == 'TOP 1,000') ? 'checked="checked"' : '' ?>  />
	    TOP 1,000&nbsp;&nbsp;&nbsp;
	    <input type="checkbox" name="" value="" <?php echo (strtoupper($application['latest_ranking_of_company']) == 'BEYOND 1,000') ? 'checked="checked"' : '' ?>  />
	    BEYOND 1,000&nbsp;&nbsp;</td>
	  </tr>
	<tr>
	  <td valign="top">6.</td>
	  <td colspan="3" valign="top">
    <label><input type="checkbox" name="input2" value="" <?php echo (strtoupper($application['sector']) == 'PRIVATE') ? 'checked="checked"' : '' ?> />
PRIVATE</label>
  <label><input type="checkbox" name="input2" value="" <?php echo (strtoupper($application['sector']) == 'GOVERNMENT') ? 'checked="checked"' : '' ?> />
  GOVERNMENT&nbsp;&nbsp;</label>
  <?php $isSectorOthers = (!in_array(strtoupper($application['sector']),array('PRIVATE','GOVERNMENT')) && $application['sector'] != '') ? true : false ?>
  <label><input type="checkbox" name="input2" value="" <?php echo ($isSectorOthers) ? 'checked="checked"' : '' ?>  />
  OTHERS, PLEASE SPECIFY</label>
      <div class="shortxt-o"><?php echo ($isSectorOthers) ? $application['sector'] : '' ?></div>
    </td>
	  </tr>
	<tr>
	  <td valign="top">7.</td>
	  <td colspan="3" valign="top"><label>NO. OF LINES APPLIED FOR</label>
      <div class="longtxt"><?php echo (isset($application['number_of_lines_applied_for'])) ? $application['number_of_lines_applied_for'] : '' ?></div>
    </td>
	  </tr>
	<tr>
	  <td valign="top">8.</td>
	  <td colspan="3" valign="top">AUTHORIZED CORPORATE/OFFICER SIGNATORY*</td>
	  </tr>
	<tr>
	  <td valign="top">&nbsp;</td>
	  <td colspan="3" valign="top"><table width="640" border="0">
	    <tr>
	      <td width="300">1. <?php echo (isset($application['authorized_corporate_officer_signatory1'])) ? $application['authorized_corporate_officer_signatory1'] : '' ?></td>
	      <td width="139">&nbsp;</td>
	      <td width="187">&nbsp;</td>
	      </tr>
	    <tr>
	      <td>POSITION IN COMPANY</td>
	      <td>CONTACT NO.</td>
	      <td>EMAIL ADDRESS</td>
	      </tr>
	    <tr>
	      <td><div class="longtxt"><?php echo (isset($application['authorized_corporate_officer_signatory1_position'])) ? $application['authorized_corporate_officer_signatory1_position'] : '' ?></div></td>
	      <td><div class="shortxt"><?php echo (isset($application['authorized_corporate_officer_signatory1_contact_number'])) ? $application['authorized_corporate_officer_signatory1_contact_number'] : '' ?></div></td>
	      <td><div class="shortxt"><?php echo (isset($application['authorized_corporate_officer_signatory1_email_address'])) ? $application['authorized_corporate_officer_signatory1_email_address'] : '' ?></div></td>
	      </tr>
	    <tr>
	      <td colspan="2">AUTHORIZED CORPORATE/OFFICER SIGNATORY*</td>
	      <td>&nbsp;</td>
	      </tr>
	    <tr>
	      <td>2. <?php echo (isset($application['authorized_corporate_officer_signatory2'])) ? $application['authorized_corporate_officer_signatory2'] : '' ?></td>
	      <td>&nbsp;</td>
	      <td>&nbsp;</td>
	      </tr>
	    <tr>
	      <td>POSITION IN COMPANY</td>
	      <td>CONTACT NO.</td>
	      <td>EMAIL ADDRESS</td>
	      </tr>
	    <tr>
	      <td><div class="longtxt"><?php echo (isset($application['authorized_corporate_officer_signatory2_position'])) ? $application['authorized_corporate_officer_signatory2_position'] : '' ?></div></td>
	      <td><div class="shortxt"><?php echo (isset($application['authorized_corporate_officer_signatory2_contact_number'])) ? $application['authorized_corporate_officer_signatory2_contact_number'] : '' ?></div></td>
	      <td><div class="shortxt"><?php echo (isset($application['authorized_corporate_officer_signatory2_email_address'])) ? $application['authorized_corporate_officer_signatory2_email_address'] : '' ?></div></td>
	      </tr>
	    </table></td>
	  </tr>
	<tr>
	  <td valign="top">9.</td>
	  <td colspan="3" valign="top">AFTER SALES SIGNATORY/IES (If you are unavailable*)</td>
	  </tr>
	<tr>
	  <td valign="top">&nbsp;</td>
	  <td colspan="3" valign="top"><table width="640" border="0">
	    <tr>
	      <td width="209">1. <?php echo (isset($application['after_sales_signatory_ies1'])) ? $application['after_sales_signatory_ies1'] : '' ?></td>
	      <td width="182">&nbsp;</td>
	      <td>&nbsp;</td>
	      </tr>
	    <tr>
	      <td>POSITION IN COMPANY</td>
	      <td>CONTACT NO.</td>
	      <td>EMAIL ADDRESS</td>
	      </tr>
	    <tr>
	      <td><div class="longtxt"><?php echo (isset($application['after_sales_signatory_ies1_position'])) ? $application['after_sales_signatory_ies1_position'] : '' ?></div></td>
	      <td><div class="shortxt"><?php echo (isset($application['after_sales_signatory_ies1_contact_number'])) ? $application['after_sales_signatory_ies1_contact_number'] : '' ?></div></td>
	      <td><div class="shortxt"><?php echo (isset($application['after_sales_signatory_ies1_email_address'])) ? $application['after_sales_signatory_ies1_email_address'] : '' ?></div></td>
	      </tr>
	    <tr>
	      <td colspan="2">AUTHORIZED CORPORATE/OFFICER SIGNATORY*</td>
	      <td width="236">&nbsp;</td>
	      </tr>
	    <tr>
	      <td>2. <?php echo (isset($application['authorized_corporate_officer_signatory3'])) ? $application['authorized_corporate_officer_signatory3'] : '' ?></td>
	      <td>&nbsp;</td>
	      <td>&nbsp;</td>
	      </tr>
	    <tr>
	      <td>POSITION IN COMPANY</td>
	      <td>CONTACT NO.</td>
	      <td>EMAIL ADDRESS</td>
	      </tr>
	    <tr>
	      <td><div class="longtxt"><?php echo (isset($application['authorized_corporate_officer_signatory3_position'])) ? $application['authorized_corporate_officer_signatory3'] : '' ?></div></td>
	      <td><div class="shortxt"><?php echo (isset($application['authorized_corporate_officer_signatory3_contact_number'])) ? $application['authorized_corporate_officer_signatory3_contact_number'] : '' ?></div></td>
	      <td><div class="shortxt"><?php echo (isset($application['authorized_corporate_officer_signatory3_email_address'])) ? $application['authorized_corporate_officer_signatory3_email_address'] : '' ?></div></td>
	      </tr>
	    </table></td>
	  </tr>
	<tr>
	  <td valign="top">&nbsp;</td>
	  <td colspan="3" valign="top"><table width="609" border="0">
	    <tr>
	      <td width="300">VAT/OV. COM EXEMPTION</td>
	      <td width="299">&nbsp;</td>
	      </tr>
	    <tr>
	      <td>VAT</td>
	      <td>OCT</td>
	      </tr>
	    <tr>
	      <td><input type="checkbox" name="input3" value="" <?php echo ($application['vat'] == 1) ? 'checked="checked"' : '' ?>  />
	        YES</td>
	      <td><input type="checkbox" name="input3" value="" <?php echo ($application['oct'] == 1) ? 'checked="checked"' : '' ?>  />
	        YES</td>
	      </tr>
	    <tr>
	      <td>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Attach BIR Certificate/Sample Account No. <?php echo isset($application['vat_bir_certificate_account_number']) ? $application['vat_bir_certificate_account_number'] : '' ?></td>
	      <td>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Attach BIR Certificate/Sample Account No. <?php echo isset($application['oct_bir_certificate_account_number']) ? $application['oct_bir_certificate_account_number'] : '' ?></td>
	      </tr>
	    <tr>
	      <td><input type="checkbox" name="input4" value="" <?php echo ($application['vat'] == 0) ? 'checked="checked"' : '' ?> />
	        NO </td>
	      <td><input type="checkbox" name="input5" value="" <?php echo ($application['oct'] == 0) ? 'checked="checked"' : '' ?>  />
	        NO </td>
	      </tr>
	    </table></td>
	  </tr>
	</table>















<div class="page">
	<table width="676" border="0" cellpadding="3" cellspacing="0">
  <tr>
	  <td colspan="3"><img src="/images/print/globelogo.png" alt="" width="120" height="50" border="0" /></td>
    <td align="right">Reference no.: <?php echo $application['ref_number'] ?></td>
	  </tr>
    <tr>
	  <td colspan="4" style="background-color:#2e62ad;"><h1>CORPORATE MANAGED</h1></td>
	  </tr>
	<tr>
	  <td colspan="5" style="background-color:#2f63af;"><h2>BILLING INSTRUCTION</h2>
      	<span style="font-size:11px;color:#fff; font-weight:normal">To be filled-out by the subscriber or authorized signatory requesting for linking of accounts</span>
      </td>
	  </tr>

	<tr>
	  <td colspan="5" valign="top" style="padding:10px 10px;">


      <table width="650" border="0" align="center" cellpadding="0" cellspacing="0">
  <tr>
    <td style="background-color:#3064af; padding:5px 5px"><h2>A. DETAILED BILLING STATEMENT</h2></td>
    </tr>
  <tr>
    <td>
    &nbsp;&nbsp;&nbsp;<input name="hcopy" type="checkbox" value="" <?php echo (strtoupper($application['corporate_managed_bills_sent_to']) == 'ONE RECIPIENT') ? 'checked="checked"' : '' ?> />
    Please send the hard copy of our bills to one recipient only.<br/>    </td>
    </tr>
  <tr>
    <td>


    <table width="600" border="0" cellspacing="10" cellpadding="0">
  <tr>
    <td width="293" height="0" align="left" valign="top" class="borders" style="padding:0px 5px 5px 5px">
    COMPANY NAME <br/>
    <div style="height:15px">
      <?php echo (isset($application['bill_recipient_company_name'])) ? $application['bill_recipient_company_name'] : '' ?>
    </div>
    </td>

    <td width="277" height="0" align="left" valign="top" class="borders" style="padding:0px 5px 5px 5px">
    ATTENTION <br/>
      <div style="height:15px">
        <?php echo (isset($application['bill_recipient_attention'])) ? $application['bill_recipient_attention'] : '' ?>
      </div>
    </td>
  </tr>

  <tr>
    <td align="left" valign="top" class="borders" style="padding:0px 5px 5px 5px">
    ADDRESS: UNIT NO./FLOOR<br/>
    <div style="height:15px">
      <?php echo (isset($application['bill_recipient_unit_number_floor'])) ? $application['bill_recipient_unit_number_floor'] : '' ?>
    </div>
    </td>
    <td align="left" valign="top" class="borders" style="padding:0px 5px 5px 5px">
    DEPARTMENT <br/>
    <div style="height:15px">
      <?php echo (isset($application['bill_recipient_department'])) ? $application['bill_recipient_department'] : '' ?>
    </div>
    </td>
  </tr>

    <tr>
    <td height="10" colspan="2" class="borders" style="padding:0px 5px 5px 5px">
    BUILDING NAME/STREET NO./STREET NAME <br/>
    <div style="height:15px">
      <?php echo (isset($application['bill_recipient_building_street'])) ? $application['bill_recipient_building_street'] : '' ?>
    </div>
    </td>
    </tr>
</table></td>
    </tr>
  <tr>
    <td height="40"> &nbsp;&nbsp;&nbsp;<input name="hcopy" type="checkbox" value="" <?php echo ($application['corporate_managed_bills_sent_to'] == 'Assignees') ? 'checked="checked"' : '' ?> />
      Please send the hard copy of our bills to the assignees at our business address (as indicated in this form).<br/>    </td>
    </tr>
  <tr>
    <td style="background-color:#3064af; padding:5px 5px"><h2>B. BILL SUMMARY</h2></td>
    </tr>
  <tr>
    <td height="50">
    Would you like to receive a bill summary?
    &nbsp;&nbsp;&nbsp;<input name="hcopy" type="checkbox" value="" <?php echo ($application['receive_bill_summary'] == 1) ? 'checked="checked"' : '' ?> />yes
    &nbsp;&nbsp;&nbsp;<input name="hcopy" type="checkbox" value="" <?php echo ($application['receive_bill_summary'] == 0) ? 'checked="checked"' : '' ?> />no
    </td>
    </tr>
  <tr>
    <td height="30"><input name="hcopy" type="checkbox" value="" <?php echo ($application['bill_soft_copy_to_email_address'] == 1) ? 'checked="checked"' : '' ?> /> Please send soft copy of bills to email address</td>
    </tr>
   <tr>
    <td height="30"><input name="hcopy" type="checkbox" value="" <?php echo ($application['bill_hard_copy_to_business_address'] == 1) ? 'checked="checked"' : '' ?> /> Please send hard copy of bills to our business address (as indicated in this form)</td>
    </tr>
   <tr>
    <td style="padding-left:20px">
    <div class="borders" style="width:500px; height:15px; padding:10px 10px">
    	<div class="fl">CONTACT NAME: </div>
    	<div style="width:350px; margin-left:25px" class="fl">
        <?php echo (isset($application['bill_summary_contact_name'])) ? $application['bill_summary_contact_name'] : '' ?>
      </div>

    </div>
    <div class="borders" style="width:500px; height:15px; padding:10px 10px">
    	<div class="fl">CONTACT NUMBER: </div>
    	<div style="width:350px; margin-left:10px" class="fl">
        <?php echo (isset($application['bill_summary_contact_number'])) ? $application['bill_summary_contact_number'] : '' ?>
      </div>
    </div>
    <div class="clear"></div>
    </td>
    </tr>
</table>
      </td>
	</tr>
	</table>



<!-- ===================================================================================================== -->
<!-- ===================================================================================================== -->




	<table width="676" border="0" cellpadding="3" cellspacing="0">

	<tr>
	  <td colspan="5" valign="top" style="padding:0px 10px 10px 10px;">


      <table width="650" border="0" align="center" cellpadding="0" cellspacing="0">
     <tr>
       <td>
       &nbsp;&nbsp;&nbsp;<input name="hcopy" type="checkbox" value="" <?php echo (strtoupper($application['bill_summary_type']) == 'ONE SUMMARY FOR COMPANY') ? 'checked="checked"' : '' ?>/>
       I would like to see one bill summary for our company    <br/>
       &nbsp;&nbsp;&nbsp;<input name="hcopy" type="checkbox" value="" <?php echo (strtoupper($application['bill_summary_type']) == 'BREAKDOWN PER DEPARTMENT') ? 'checked="checked"' : '' ?> />
       I would like to see the breakdown per department
       </td>
    </tr>
  <tr>
    <td>

      <br/>
       <table width="600" border="0" align="center" cellpadding="0" cellspacing="0" bordercolor="#0099FF">
  <tr>
    <td align="center" valign="top" class="bt bl br">DEPARTMENT</td>
    <td align="center" valign="top" class="bt br">CONTACT NAME/NO.</td>
    <td align="center" valign="top" class="bt br">BILL CUT-OFF	</td>
    <td align="center" valign="top" class="bt br">CORPORATE ID</td>
  </tr>
  <tr>
    <td height="30" align="left" valign="top" class="bl br bb">1.&nbsp;<?php echo (isset($application['breakdown_department1'])) ? $application['breakdown_department1'] : '' ?></td>
    <td height="30" align="left" valign="top" class="br bb">1.&nbsp;<?php echo (isset($application['breakdown_department1_contact_name_number'])) ? $application['breakdown_department1_contact_name_number'] : '' ?></td>
    <td height="30" align="left" valign="top" class="br bb">1.&nbsp;<?php echo (isset($application['breakdown_department1_bill_cut_off'])) ? $application['breakdown_department1_bill_cut_off'] : '' ?></td>
    <td height="30" align="left" valign="top" class="br bb">1.&nbsp;<?php echo (isset($application['breakdown_department1_corporate_id'])) ? $application['breakdown_department1_corporate_id'] : '' ?></td>
  </tr>
  <tr>
    <td height="30" align="left" valign="top"  class="bl br bb">2.&nbsp;<?php echo (isset($application['breakdown_department2'])) ? $application['breakdown_department2'] : '' ?></td>
    <td height="30" align="left" valign="top" class="br bb">2.&nbsp;<?php echo (isset($application['breakdown_department2_contact_name_number'])) ? $application['breakdown_department2_contact_name_number'] : '' ?></td>
    <td height="30" align="left" valign="top" class="br bb">2.&nbsp;<?php echo (isset($application['breakdown_department2_bill_cut_off'])) ? $application['breakdown_department2_bill_cut_off'] : '' ?></td>
    <td height="30" align="left" valign="top" class="br bb">2.&nbsp;<?php echo (isset($application['breakdown_department2_corporate_id'])) ? $application['breakdown_department2_corporate_id'] : '' ?></td>
  </tr>
  <tr>
    <td height="30" align="left" valign="top"  class="bl br bb">3.&nbsp;<?php echo (isset($application['breakdown_department3'])) ? $application['breakdown_department3'] : '' ?></td>
    <td height="30" align="left" valign="top"  class="br bb">3.&nbsp;<?php echo (isset($application['breakdown_department3_contact_name_number'])) ? $application['breakdown_department3_contact_name_number'] : '' ?></td>
    <td height="30" align="left" valign="top"  class="br bb">3.&nbsp;<?php echo (isset($application['breakdown_department3_bill_cut_off'])) ? $application['breakdown_department3_bill_cut_off'] : '' ?></td>
    <td height="30" align="left" valign="top"  class="br bb">3.&nbsp;<?php echo (isset($application['breakdown_department3_corporate_id'])) ? $application['breakdown_department3_corporate_id'] : '' ?></td>
  <tr>
    <td height="30" align="left" valign="top"  class="bl br bb">4.&nbsp;<?php echo (isset($application['breakdown_department4'])) ? $application['breakdown_department4'] : '' ?></td>
    <td height="30" align="left" valign="top"  class="br bb">4.&nbsp;<?php echo (isset($application['breakdown_department4_contact_name_number'])) ? $application['breakdown_department4_contact_name_number'] : '' ?></td>
    <td height="30" align="left" valign="top"  class="br bb">4.&nbsp;<?php echo (isset($application['breakdown_department4_bill_cut_off'])) ? $application['breakdown_department4_bill_cut_off'] : '' ?></td>
    <td height="30" align="left" valign="top"  class="br bb">4.&nbsp;<?php echo (isset($application['breakdown_department4_corporate_id'])) ? $application['breakdown_department4_corporate_id'] : '' ?></td>
  </tr>
   <tr>
    <td height="30" align="left" valign="top" class="bl br bb">5.&nbsp;<?php echo (isset($application['breakdown_department5'])) ? $application['breakdown_department5'] : '' ?></td>
    <td height="30" align="left" valign="top" class="br bb">5.&nbsp;<?php echo (isset($application['breakdown_department5_contact_name_number'])) ? $application['breakdown_department5_contact_name_number'] : '' ?></td>
    <td height="30" align="left" valign="top" class="br bb">5.&nbsp;<?php echo (isset($application['breakdown_department5_bill_cut_off'])) ? $application['breakdown_department5_bill_cut_off'] : '' ?></td>
    <td height="30" align="left" valign="top" class="br bb">5.&nbsp;<?php echo (isset($application['breakdown_department5_corporate_id'])) ? $application['breakdown_department5_corporate_id'] : '' ?></td>
  </tr>
</table>


</td>
    </tr>
  <tr>
    <td height="40">
        <div  style="width:500px; margin:0 auto">CORPORATE CODE:</div>

    	<div style="width:500px; height:30px; background-color:#cbd8eb; margin:0 auto; padding:10px">

        <?php echo (isset($application['corporate_code'])) ? $application['corporate_code'] : '' ?>

        </div>

    </td>
    </tr>





</table>
      </td>
	</tr>
	</table>
</div>